Aim: Over 40% of cancer patients report clinical symptoms of anxiety or depression. Early detection through repeated screening can facilitate timely intervention, however reported barriers include time pressures, mental health stigma, and prioritisation of other health needs. Web-based screening may offer a viable solution to increase detection of anxiety and depression. This pilot study aimed to investigate the acceptability and perceived utility of repeated online psychological screening in a sample of patients receiving chemotherapy treatment.
Method: Forty-four patients were recruited from Austin Health Day Oncology Unit. Participants completed the Distress Thermometer (DT) and Problem Check-list, and the Hospital Anxiety and Depression Scale (HADS) on their personal electronic devices at 0, 8, and 16 weeks after their first chemotherapy session. Alerts were automatically sent to the study team for clinically significant scores. Patients (n=33) and multidisciplinary staff (n=4) provided feedback via survey and/or interview.
Results: Of the 44 participants, 88.6% completed questionnaires on at least two occasions, and 61.4% completed all three time points. Approximately 1 in 2 patients reported clinically significant anxiety/depression symptoms at baseline. Over one-third of individuals who were below-threshold at baseline went on to report significant symptoms at week 8 and/or 16. DT scores were significantly positively correlated with HADS at all time points (p <.01). Almost all patients (>90%) reported that completing the online questionnaires was easy, comfortable, and not burdensome. Qualitative feedback indicated that patients and staff found repeated screening to be beneficial. For example, patients commented that regular screening motivated them to reflect on their wellbeing and seek support where needed.
Conclusion: This pilot study reinforces the benefits of repeated psychological screening during cancer care. Web-based screening was found to be largely acceptable and useful by patients receiving chemotherapy treatment.
Further research is warranted to explore methods to enhance implementation in resource-limited hospital settings.